MEDICARE: K DEAN REEVES MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	04-19247	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780844324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K DEAN REEVES MD PA

Provider Business Mailing Address
First Line	:	4740 EL MONTE ST
Second Line	:
City	:	SHAWNEE MISSION
State	:	KS
Zip	:	66205-1348
Country	:	US
Telephone Number	:	913-362-1600
Fax Number	:	913-362-4452

Provider Business Practice Location Address
First Line	:	4740 EL MONTE ST
Second Line	:
City	:	SHAWNEE MISSION
State	:	KS
Zip	:	66205-1348
Country	:	US
Telephone Number	:	913-362-1600
Fax Number	:	913-362-4452

Authorized Official
Title or Position	:	OWNER
Name	:	KENNETH DEAN REEVES
Credential	:	M.D.
Telephone Number	:	913-362-1600

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	06/16/2008

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Directions to “K DEAN REEVES MD PA ” Practice Location

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